Supporting Workers Is More Needed In These Times, Part 1

by Dr. Arcelita Imasa

These times can be empowering for many of us, but for others, they can be anxiety-inducing—particularly for immigrants and those facing challenges with their residency status.

Regardless of these circumstances, low-income workers in Hawaii continue to face immense difficulty due to the state’s high cost of living. While we have seen an increase in the minimum wage since last year, many workers still fall through the cracks and fail to receive fair pay.

But first, who are the low-income workers in Hawaii?

They are individuals employed in jobs that often pay wages insufficient to meet the state’s exceptionally high cost of living.

Many work in tourism and hospitality—as housekeepers, hotel staff, waiters, bartenders, and tour guides—often earning minimum wage or relying heavily on tips. Others are retail workers, such as cashiers, sales associates, and customer service staff in stores or malls.

Additionally, food service workers—including fast food employees, cooks, dishwashers, and servers—make up a large portion of low-income workers. So do health care and caregiving workers, such as home health aides, caregivers, and nursing assistants, who often work long hours for inadequate pay.

Lastly, janitorial and maintenance staff, like custodians, cleaners, and general maintenance workers, are also part of this group, enduring long, physically demanding hours for low wages.

Hawaii has one of the highest costs of living in the United States, driven by expensive housing, utilities, and food. This makes low-income work particularly challenging.

Compounding the problem, many tourism-related jobs are seasonal, offer limited benefits, and are highly susceptible to economic fluctuations. The state’s heavy reliance on the service and tourism industries limits opportunities for workers to find jobs in higher-paying fields.

As a result, many low-income workers take on multiple jobs just to make ends meet. However, this often creates a new set of problems, as juggling multiple jobs can still fail to provide sufficient income or benefits.

As a doctor, I find it particularly difficult to convince my patients who are low-income workers to limit themselves to one job so they can prioritize their health.

Unfortunately, many only come to the clinic when they are already seriously ill. This troubling pattern should concern us all. High blood pressure, for example, is a very common medical condition that can lead to an enlarged heart if untreated.

While a “large heart” symbolizes kindness and generosity in metaphorical terms, in medical terms, it is far from desirable. Conditions such as heart disease or heart attacks are silent killers, as are other chronic conditions like diabetes, high cholesterol, and kidney failure.

Treating these long-term medical conditions requires consistent follow-up care, regular maintenance medications, and proper time management—none of which are easy to achieve when working 16-hour days across multiple jobs.

Many patients forego treatment entirely because their demanding schedules make it impossible to prioritize their health.

One source of hope for low-income workers, however, is the growing solidarity shown by others.

Solidarity in this context means understanding the struggles of low-income workers, advocating for their rights, and actively working toward improving their living and working conditions.